Retrieval and Results

I was a lot less nervous about the procedure and a lot more nervous if there would be any eggs in those fifteen follicles for the retrieval.

It was scheduled for 9am on Tuesday so we triggered at 11pm on Sunday. It was just one injection but everything felt so much more important for that one.

I couldn’t eat after midnight Monday night, but I also could drink anything (even water) for 5 hours before the procedure. I thought about getting up at 4, but we decided if I could sleep that was the most important thing. I think I woke up at 5am. David was convinced he wasn’t going to eat breakfast in solidarity, but I encouraged him to get something in his stomach not knowing how long it would take me to wake up.

We get there, and we are both trying to stay calm as they take us back and I get into my gown. We have to sign the final papers and consent to the anesthesiologist.

I’m not sure why I had it in my head that we would be in one of the exam rooms but we were not. This was like full on surgery room. David didn’t get to go back with me and may have cried a little. I was just ready to be where I could get comfortable again. I was looking forward to waking up without the pressure. And I did. I could tell immediately when I opened my eyes things were better. I was loopy but there wasn’t any immediate pain. David helped me get dressed and we were off. We got there at 8:15 and were out by 10. And they informed me before we left that they got 7 eggs!!!! I was elated that there were eggs in there and apparently told the nurse all of our plans for our kids. I don’t remember any of that part.

My post op treat was a milkshake from Chick-Fil-a and then it was back to the sofa for me. I napped for a couple of hours, but I felt like I could take on the world. I could walk and wasn’t cramping anymore. It wasn’t until that night around bedtime that I started feeling having had surgery. I took Tylenol but should have taken the hydrocodone they prescribed me. It wasn’t super painful, but I could not lay there without discomfort. Good or bad, I went to work the next day, still just taking regular Tylenol. I did feel better without the swelling of my follicles, but after a couple of hours, I was trying to decide if I could get off the floor if I laid down. I didn’t want to chance it and stuck it out until noon.

Laying down has never been such a relief as we waited for results from the fertilization.

When they finally came in I’m not sure if I was recovered enough to read them without David there. We had 7 eggs. 5 were mature enough. Only 2 fertilized. Since they were using icsi I was really surprised that more hadn’t been fertilized. I was thinking maybe losing one but three was a blow to the gut.

Still we tried staying positive and started praying. We went from thinking we might get extras the first round to wondering if either would get to day five. Thursday the progesterone in oil kicked in to my recovery, and I had the worst constipation of my life (maybe tmi). If I have one recommendation, it is to start colace tablets. I was really afraid that we would have to cancel the transfer because of stupid constipation. It hurt so badly and pushing just tore me up. Everything hurt. If I had started the tablets sooner, I don’t think it would have been a problem, but I waited. I will never wait again! I really doubt I would have had pain if I had been smart about that part. I tried not to overdo but I was exhausted from my bathroom trips so I basically did nothing except go to work and then come home to the sofa.

IVF Injections – Day 9

I had a new doctor at this appointment since it was on a Saturday and they only had one doctor on call. I can’t complain because he did find fourteen follicles (YAY!), but my word, did this ultrasound hurt. He pushed on my ovaries looking for the follicles, and I just about came off the table. With my hormones jumping up, my emotions were a little more on my sleeve than normal (which David was not too excited about). When I saw he found fourteen, I was fine with it, but at the time, it was very not fine.

They informed us after the ultrasound that we would be doing our trigger shot the next day (Sunday) and our retrieval would be Tuesday! It was such a relief. It was such a weight that was lifted. I am so ready to not feel like this any more. I’m fine with needles. They don’t bother me, but this cycle has made me dislike needles with a passion. I know I have two months of progesterone in front of me after this, but I would love to not see a needle for a very long time when this is done.

Results:

Left Ovary Follicles: 17mm, 20mm, 13mm, 16mm, 16mm, 9mm, 10mm, 15mm, 21mm, 13mm

Right Ovary Follicles: 16mm, 15mm, 17mm, 11mm

Estradiol: 1144.8

IVF Injections – Day 7

We are seven days in and things are beginning to get uncomfortable. I’m not going to say painful because there really hasn’t been too much pain. It is just uncomfortable. Sleeping. Going to the bathroom. Walking. Sitting. I’m beginning to feel this uncomfortable ache in my abdomen.

The ultrasound this morning was pretty basic, but she said that I was progressing well and at my next appointment I should get an estimate for my retrieval! Because of how well things looked, she had me start my Ganirelix injections that day. YAY another injection, but at least it meant that we were getting closer.

I was a little concerned, though, because last ultrasound she had thirteen follicles and this time, she only found nine. I was shocked and panic began setting in. The nurse said it was wasn’t anything to worry about, but I couldn’t understand what was happening. Apparently, she didn’t measure them all and was just getting the sizes of the ones over 10mm. That’s one way to give me a heart attack!

Results

Left Ovary Follicles: 16mm, 17mm, 12mm, 14mm, 10mm

Right Ovary Follicles: 11mm, 11mm, 7mm, 11mm

Estradiol: 757.4

Day 5 – Ultrasound

I had a pretty good idea that the medication was working based on how I was feeling, but   I am glad that I had an appointment today. Knowing that everything was going and going well was very exciting.

No changes to my meds. No changes to my protocols. Everything is business as usual, and I go back in on Day 7.

YAY!!

Results: 12 Follicles

Left Ovary – 11mm, 7mm, 7mm, 7mm, 7mm, 9mm, 13mm

Right Ovary – 8mm, 7mm, 8mm, 6mm, 5mm

Injections – Day 3 (Mother’s Day)

We are on Day 3 of injections and the tired has officially hit. I literally want to do nothing but sleep.

We are still doing 150u of Follistim in the morning and evening with Dexamethasone in the morning. My stomach is already starting to bruise so putting the needle in is beginning to be painful. Or the hormones are making me more of a pansy, one or the other. We’ve starting icing after the injection, but that is a little hard to do when you slept in (because you’re tired) before work and have to race around to get there in time (which may or may not have happened).

We were planning on doing a brunch for David’s family for Mother’s Day (to help me keep my mind off of it), so I had a massive spread planned. Thankfully, David is good in the kitchen because I was basically worthless during the most of the baking. We got everything done, but I was exhausted. As soon as they left, I laid down and took a nap. While it did help me to feel a little better, it did not cure the tired. At this rate, I’m not sure if it is going to go away. Naps may become necessity for function at this rate.

I usually do not do too well on Mother’s Day because it feels like we’ve been trying to reach that status for so long. There is such disappointment when this holiday comes around. This time, though, it wasn’t quite as difficult. I’m not sure if it is because of the IVF or if it is because I was too tired to care, but either way, I was glad that the day passed without tears. With the headache I’ve been nursing for the past three days, crying sounds extremely painful.

I’m really glad that I only work part time right now with being this tired. I’m pretty sure I can get through half a day before needing to lay down, or I’m hoping anyway!

My first cycle ultrasound is Tuesday (day 5), and I am praying that these symptoms mean this is working!

Injections – Day 1

I actually slept last night, which was an answer to prayer. I had to talk myself down a few times yesterday as my nerves flared, but we got to 7am this morning.

I dialed my Follistim to 150u and poked it into myself. Yep, I did the first one.

The needle is tiny, so the sticking did not hurt, but it did burn a little going in. It was over and done in just a few seconds. I popped my vitamins and Dexamethasone and went to work.

I was jittery for a while afterward, but I’m not sure if that was just nerves or the meds.

Two hours later, though, my period started. Definitely NOT what I was expecting today. I contacted my nurse, and she said that this can happen since I’ve been off of the birth control for a few days.

The problem is, I have no idea if the cramping and pain that I am feeling is the injection or my period. Today has not been a fun day, and I was not expecting the sofa to be such a good friend this early in the process, but alas, we cannot control when Aunt Flow comes a knocking, even on IVF.

Since I have been cramping quite a bit today, though, I have noticed how much more that I twist and bend. Those are big no no’s, but I had no idea how much I do when I’m at work. Moving my whole body or rolling my chair over to where I need to be instead of turning felt strange, but the cramping did make twisting or bending motions much more evident that I needed to stop.

 

Baseline Ultrasound

When they said I was going to be on a May IVF cycle, I imagined that I would start in the first week of May, but it was May 8th (my sister’s birthday :).

David took off work because I knew I would be nervous and even though I wouldn’t learn anything at the appointment, we both wanted to be there to start this.

They did my blood work first, and day of all days, the nurse couldn’t find my vein the first stick. She apologized profusely, and hopefully we got it out of the way so it won’t happen again (please Lord).

They did a transvaginal ultrasound (which David hadn’t seen done before and was a little surprised to actually see it happening). Since my last one, no cysts had popped up. My doctor had given me birth control to help get rid of my ovarian cysts in the past, so I was pretty sure their wouldn’t be.

The baseline is to make sure that nothing is happening, and she said my ultrasound looked good. As long as my blood work came back that my hormones were what they needed to be, I was there!

She told me that my appointments during my cycle would be about five minutes to be in and out so it will take me longer to get there than it will to be in the office!

That afternoon they got my blood work filled in and updated my flowsheet – my first day of injections is Friday and I was able to stop taking the birth control that day! I had it in my head that they would have me starting sooner, but I’m doing the Follistim/Ganirelix protocol so waiting a few days after stopping my birth control is normal apparently.

I had been prepared to start sooner, but having a few days will be nice. I’ll be able to clean the house one more time and prep a little for having family over for Mother’s Day this weekend.

Another surprise was that I thought I would get a schedule for my IVF cycle when they started my flowsheet just to give me an idea as to when things would be happening throughout the cycle. Since things may change at every appointment, though, they only give from one appointment to the next. I have from when my injections start on Friday, to my cycle appointment on Tuesday. Five days. Then the next time may only be two days.

One day at a time may become literally my life, and I am so excited.

As nervous as I am about how the meds are going to affect me, I am glad that we are starting. I’ve done all that I know to do to prepare. I’ve been drinking minimally 80 ounces of water, 16 ounces of milk, and 16 ounces of herbal teas every day (Yes, I did read about how much I should be drinking during this). I have a months worth of meals in the freezer. David has had lessons in cleaning and dishes and laundry. I’ve got friends on standby if I need a ride to the doctors. I am just ready to start.

Saline Infused Sonogram/Trial Transfer (SIS/TT)

Today I had the required Saline Infused Sonogram/Trial Transfer. This is where they map out my uterus to see how it looks (again) and see where they are going to be putting my embryo baby (Oh Please Lord!) when the time comes as well as making sure there are no fibroids or issues internally that they would need to take care of before we started IVF.

I was terribly afraid that this was going to end up being another HSG experience and have to go through all of that pain again. While this was not comfortable, it was not nearly as painful (YAY!!). They threw off my grove though a little because when I checked in, the nurse told me NOT to use the bathroom since I needed a full bladder…. Why was that not told to me before??

So I spent my ten minute waiting room wait chugging water. By the time the nurse took me back I was not uncomfortable, but I did need to pee. Crisis averted.

She let me undress from my waist down and hide under their little sheet thing. If you haven’t seen pictures of the ultrasound machine. Here you go.

Yes, they use both of those probes for this.

It’s not really terrifying, but it’s the only thing in the room with you while you are undressing.

The doctor and nurse come in and are chatting and set straight to work.

Part 1 – The doctor is sticking a tube inside me while the nurse uses the probe on my abdomen. This is uncomfortable, but the tube is small so it wasn’t really painful. Or it wasn’t until she hit the top of my uterus…. It wasn’t bad for long, but it was like an instant hard cramp.

Part 2 – So this is where it actually became painful for me. They inserted the balloon catheter inside me and when they inflate that balloon is when the cramping  got to be bad. She only had to inflate it half way which did help tremendously. This is where they insert the probe inside me and push around inside (woo). The balloon is definitely the most painful part.

She said that they only used a little bit of saline instead of dye injection like the HSG was and that liquid was what caused me to cramp. Her hope was that since she did not use much that my cramping would be less.

Even with this being a two part process, the whole thing lasted about five minutes. She was in and out and really never stopped talking about her workout to the nurse. Once it was over, she said that I looked good and there were no issues. The only thing was that she wanted my bladder a little more full for the next procedure. I didn’t tell her that I just started chugging water about fifteen minutes before that!

It was far less climactic than the HSG was, but I think a lot of that had to do with it being at the fertility center and not a hospital. I preferred a small room with the doctor that I had seen before with a small ultrasound machine over a tech I had never met before running a giant x-ray.

 

Starting Suppression Meds

At 8:00 tonight I start taking my birth control meds and my z-pak pills. This is the first step of the IVF – suppression – and it comes before the stimulation. Basically they want to start at zero so that they can tell the body what they want it to do instead of just letting it takes its normal course.

Normally, I may release one egg per cycle. With IVF, they want me to release as many eggs as possible. In our education packet, they said that is anywhere between 8 and 20.

Since these meds stop everything, the doctor has more control which also helps to prevent the dreaded Ovarian Hyperstimulation Syndrome or OHSS*.

Learning about the possibilities of what could go wrong was probably the hardest part of our education packet. I definitely want to know what issues this can cause, but when this is basically our best chance, it felt more like these were the thing that we were willing to risk. OHSS is when fluid begins to collect in the abdomen. Mild forms are uncomfortable, cause you to gain a little weight in your abdomen, and usually goes away in less than a week without meds. This happens in less than 10% of patients.

Severe OHSS is massive amounts of fluid that collect in the abdomen and usually needs medical help to get it to go down. You can gain up to 30lbs on this one, and it is quite painful.

Neither one sound awesome so I am all about anything that will help prevent that from happening.

One thing that I keep reading is how important it is to up my water intake during this process. While it seems like it should be easy, the general consensus is starting to make this a habit now is important so that when I am on the stimulation drugs, it is ingrained in my head. When I am uncomfortable and needing to pee every minute anyway, the last thing I’m going to want is to think about drinking more water.

They’ve ordered my prescriptions from Caremark Specialty so I am waiting to her what my bill from them is going to look like. I’m not sure how long I’m supposed to wait before following up about the prescriptions, but curiosity is beginning to set in. I really want to know how much this is going to cost. They are starting me on the Ganirelix protocol instead of the Lupron protocol, so I know that much at least. The good thing about Ganirelix is that it comes in pre filled syringes so yay?

I feel like I know so much more about IVF than I have right now, but without having gone through this before, I feel like I know nothing. It’s new and scary and there are so many unknowns.

 

*I am not a doctor and this information is not meant to give medical advice. This is information that was provided to us. If you have a health issue or think you are dealing with OHSS, please contact your doctor immediately!

 

The Process of Starting IVF

 

We found out last week that we won’t know how much is going to come out of our pockets until we start toward an IVF cycle. After talking about it over the weekend, we decided that we could try for May. We aren’t planning on traveling. It is before the summer and super hot summer weather. It just seemed to work, and this way we will know how much it is going to cost. We can always postpone it a coupe of months if we need to once we get those numbers, but if they are what we are guessing, May should work with our budget.

So Tuesday (March 28th) I emailed the fertility center saying let’s go for May and by the way my March period started that day as well, just because they have been keeping track.

I get an email back that afternoon from their IVF coordinator saying that they are setting me up in the system, and that she is ordering my birth control meds THAT DAY.

I think I stared at the email for a solid five minutes letting the idea that starting in May means that we actually start now. For some reason this hadn’t registered to me, but it was super exciting at the same time. Plus they are going to get all of our insurance sorted before our contract appointment on April 19th. FINALLY.

As soon as you say we are ready to start, it’s like it puts a fire under everyone. Suddenly instead of you trying to sort things out, you are given check lists, and emails, and information packets, and deadlines.

Most of the checklist we have already had done since it was part of the process to sort out what was wrong with us in the first place. Primarily now it is contracts and education about IVF and the medications we are going to be administering (David is more nervous about the needles than I am, even though they are going in me).

Before, it felt like this might happen someday. Now, it finally feels like this may be happening. I’m trying to not get too excited because a lot of the information we are having to read says a lot about how there is a large possibility that this will not work. We are praying that it does, though.

I informed my boss yesterday, and she was very helpful and willing to work with my schedule (especially on short notice). David’s boss is on vacation this week, but there are really only two days that are required for him to be present and accounted for (according to the schedule they gave me). I’d like him to be at every appointment with me, but it sounds like there are going to be a lot of them so I’m pretty sure I can manage the easy ones by myself.

We also scheduled my Saline Infused Sonogram and Trial Transfer (SIS/TT) for next week. Basically it is the HSG (NOOOOOOO) again except this is at the fertility center (YAY), and they are using saline instead of dye. The process helps them to map where they are going to be transferring the embryo at the end of the IVF process (YAYAY!). I think knowing what this is for is going to make this one a lot easier.

Everything is moving quickly, and I am not upset about that. Knowing that this IVF cycle will be completely finished by June 2nd is actually a relief. I’m not excited about the medications I’m going to be on. I’m not excited about the retrieval, but I am so glad that we are starting this process now instead of waiting a few more months.